| Marathon Medical Pc | |
|
1306 E 7th St Suite C Auburn IN 46706-2536 | |
| (260) 925-0666 | |
| (920) 925-0669 |
| Full Name | Marathon Medical Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1306 E 7th St, Auburn, Indiana |
| Authorized Official Name and Position | Trina C Chapman-smith (OWNER) |
| Authorized Official Contact | 2609250666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marathon Medical Pc 1306 E 7th St Suite C Auburn IN 46706-2536 Ph: (260) 925-0666 | Marathon Medical Pc 1306 E 7th St Suite C Auburn IN 46706-2536 Ph: (260) 925-0666 |
| NPI Number | 1427011386 |
|---|---|
| Provider Enumeration Date | 04/10/2006 |
| Last Update Date | 10/06/2014 |
| Medicare PECOS PAC ID | 1355478793 |
|---|---|
| Medicare Enrollment ID | O20100416000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427011386 | NPI | - | NPPES |
| 200185690A | Medicaid | IN | |
| 000000104774 | Other | IN | BC/BS GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01038514 (Indiana) | Primary |
| Provider Name | Trina Coleen Chapman-smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285634568 PECOS PAC ID: 6709920705 Enrollment ID: I20100215000120 |
| Provider Name | Crystal Nicole Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902267057 PECOS PAC ID: 1850699752 Enrollment ID: I20160408001611 |
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